Curative effect of three-dimensional porous core decompression combined with autologous bone marrow transplantation on phase Ⅰ, Ⅱ avascular necrosis of the femoral head / 中国组织工程研究

BACKGROUND: Hip-preserving treatment is advocated in the treatment of early avascular necrosis of the femoral head.OBJECTIVE: To compare the clinical efficacy of simple core decompression and three-dimensional porous core decompression combined with autologous bone marrow transplantation on early avascular necrosis of the femoral head.METHODS: Thirty patients (39 hips) with early avascular necrosis of the femoral head at phase I-II according to the staging criteria of the Association Research Circulation Osseuse (ARCO) who had been admitted to the First Affiliated Hospital of Luzhou Medical University between March 2011 and May 2016 were surgically treated and followed up.Seventeen patients (22 hips, trial group) were treated with three-dimensional porous core decompression combined with autologous bone marrow transplantation, including 10 cases of ARCO stage I and 12 cases of ARCO stage II; the other 13 patients (17 hips, control group) were treated with simple core decompression, including 7 cases of ARCO stage I and 10 cases of ARCO stage II. Harris scores, X-ray and magnetic resonance imaging were used to evaluate the surgical efficacy at 1, 3, 6, 9, 12, 18, 24, 30, 36 months after the operation.RESULTS AND CONCLUSION: The incision healed primarily in all patients, and no infection occurred. The follow-up lasted for 1-3 years (average 2.5 years). At the last follow-up, the Harris scores in both trial group and control group were significantly improved compared with the baseline (P < 0.05); moreover, the Harris scores of ARCO stage I and II patients were significantly higher in the trial group than the control group (P < 0.05). Collapse of the femoral head was observed in one hip (stage I) and one hip (stage II) of the trial group, and in three hips (stage I) and five hips (stage II) of the control group, and then hip arthroplasty was performed. The number of the patients developing collapse of the femoral head in the trial group was significantly less than that in the control group (P < 0.05). Compared with simple core decompression, three-dimensional porous core decompression combined with autologous bone marrow transplantation is more adept to improve patient's function and delay disease progression in the treatment of ARCO stage I and II early avascular necrosis of the femoral head.

Impaction bone grafting with morselized bone and bone paste for acetabular defects in adult Crowe Ⅲ type developmental dysplasia of the hip / 中国组织工程研究

BACKGROUND:Considering the risk of lack of bone in revision and the bone coverage of component,it is advisable to use bone grafting to increase bone stock in patients with adult Crowe type Ⅲ developmental dysplasia of the hip (DDH) in the first total hip arthroplasty (THA).OBJECTIVE:To investigate the effectiveness of impaction bone grafting with morselized bone and bone paste for acetabular defects of adult Crowe type Ⅲ DDH in THA.METHODS:Forty cases (45 hips) of Crowe type Ⅲ DDH were enrolled,including 8 males and 32 females,aged 31-68 years.All the components were reconstructed at the anatomic acetabulum combined with deepening acetabulum and putting the centre of rotation medially and distally during THA procedures.The patients were all followed up and evaluated with Harris score,limp length,displacement of the centre of rotation,cup coverage,and postoperative complications.RESULTS AND CONCLUSION:The average follow-up was 32.7 months.Acetabular rotation centers of all the cases were recovered (near) to normal.The incisions healed by first intention and there was no complication such as infection,dislocation,prosthesis loosening.The acetabular cup prosthesis did not displace and was covered well by bone at the last follow-up,the grafted bone particles got radiological osseointegration and the bone sclerosis zone disappeared.No radiolucent lines and screw fracture were detected.The Harris scores of affected hips at the last follow-up were significantly higher than those before surgery(P=0).The average leg length was increased (2.31 ±0.18) cm.The mean cup coverage was 78.1％.The postoperative horizontal and vertical distance of the hip center were shorter than those before surgery (P=0).Reconstructing the acetabulum with autogenous morselized bone graft impaction can effectively restore the acetabular coverage,maintain the stability of acetabular cup and provide better relative bone stock in THA for Crowe type Ⅲ DDH in adult,and moreover,the short-term effect is satisfactory.

Clinical study of post-operative pain following coblation tonsillectomy and/or adenoidectomy in children with sleep-disordered breathing / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the characteristics of post-operative pain following coblation tonsillectomy and/or adenoidectomy in children with sleep-disordered breathing (SDB) and explore the correlation between the first day post-operative pain scores and age and operating time.@*METHOD@#1) A total of 113 SDB children scheduled to undergo coblation tonsillectomy and/or adenoidectomy were recruited. 113 children were divided into two groups according to the method of operation, children who underwent coblation tonsillectomy and adenoidectomy were enrolled in study group one and children who underwent coblation adenoidectomy only were in study group two. Be sides, children of study group one with a history of chronic tonsillitis were in chronic tonsillitis group, children without a history of chronic tonsillitis were in non-chronic tonsillitis group. 2) The parents scored pain in their children on a VAS (anchored by "no pain" at 0 and "worst pain" at 10) in the morning, before using any analgesics and having breakfast, over the first 3 and the seventh post-operative days. 3) Post-operative pain scores were compared between both the study group one and two and chronic tonsillitis group and non-chronic tonsillitis group. Futhermore, the correlation between the first day post-operative pain scores and age and operating time were also analysed.@*RESULT@#1) The difference of post-operative pain scores over the first 3 and the seventh post-operative days were significant between the study group one and group two (P0.05). 3) The first day post-operative pain scores was correlated with age (r=0.273, P<0.01) and operating time (r=0.423, P<0.01).@*CONCLUSION@#The first day post-operative pain scores was correlated with age and operating time. Children with a history of chronic tonsillitis were more painful than children without the history.

Clinical efficacy of combined treatment with montelukast and intranasal steroid for chronic adenoid hypertrophy in children / 临床儿科杂志

Objectives To observe the clinical efficacy of combined treatment with montelukast and intranasal steroid for chronic adenoid hypertrophy in children. Methods 47 children with chronic adenoid hypertrophy were selected and ran-domly divided into drug combination group (n=23) treated with montelukast combined with intranasal steroids for two months and control group (n=24) treated with intranasal steroids only for two months. Clinical efficacy was compared between two groups by clinical score and the result of fibronasopharyngoscopy. Results The clinical scores were 0 (0, 1.0) and 0(0, 0) at 2 weeks and 2 months after treatment in combination group, and 1.0 (1.0, 1.0) and 0 (0, 1.0) in control group. There were sig-nificant differences between two groups (Z=2.404, P<0.05;Z=2.069, P<0.05). Conclusions The clinical efficacy of combined treatment with Montelukast and intranasal steroid is better than that of treatment with intranasal steroid only in children with chronic adenoid hypertrophy.

The application septonasal bidirectional mucoperiosteal flap in treatment of refractory choanal atresia in adults / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effects of septonasal bidirectional mucoperiosteal flap in the treatment of refractory choanal atresia in adults.@*METHOD@#Analysis of 9 cases for choanal atresia was conducted. Two cases were of congenital origin and 7 cases of acquired origin, which was a complication of radiotherapy for nasopharyngeal carcinoma. The patients received transnasal endoscopic surgery using the septonasal bidirectional mucoperiosteal flap, without positioning the postoperative expansion tube. After the operation, the changes of symptoms were observed and the recurrent rate of restenosis or atresia was investigated in the follow-up time.@*RESULT@#The symptoms of nasal obstruction and mouth breathing improved significantly in the 9 patients. At an average follow-up time of 19.3 months, the new forming posterior nare remained patent. The mucoperiosteal flap had no shift or necrosis. No restenosis or atresia happened. Nasal adhesion occurred in two patients. Granulation tissue hyperplasia was found in 1 patient, who underwent endoscopic revision without recurrence.@*CONCLUSION@#The application of mucoperiosteal flap in transnasal endoscopic surgery for the choanal atresia can reduce the incidence of restenosis or atresia. Postoperative expansion tube is not mandatory.

The configuration of soft palate muscular phenotype in obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the mRNA expression of muscle phenotype and collagen of soft palate and pathology in obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#We used the Real-time PCR to test the mRNA expression of soft palate muscle myosin heavy chain (MyHC) phenotype and collagen in 12 OSAHS patients and 8 control patients. We also distinguished the muscle isoforms I , II with ATPase staining, then counted the numbers of isoforms muscle fiber.@*RESULT@#The mRNA expression of OSAHS group was more than control group in II A MyHC phenotype (P<0.01). The number of OSAHS group muscle fibre I isoform was less than control group with pH4. 3 ATPase staining (P<0.05).@*CONCLUSION@#Compare to control group, the enhancement happened in the mRNA expression of II A MyHC phenotype which can increase the velocity and power but de crease the enduring quality of muscle in OSAHS, and the reduce be in the I MyHC isoform of muscle fiber that can cause muscle velocity become slower and persistency become longer in OSAHS patients.

Clinical analyses of intranasal contact point headaches / 中国耳鼻咽喉头颈外科

OBJECTIVE This objective of this study was to investigate intranasal anatomic abnormalities in cases of contact point headaches caused by contact between the nasal septum and the lateral nasal wall,as well as the clinical outcomes in these cases treated by endoscopic sinonasal surgery. METHODS A retrospective review was performed on 58 cases that met the criteria of having contact points between the septum and the lateral nasal wall, as demonstrated by CT scans of the sinuses and endoscopic examinations. These patients underwent surgical intervention in order to correct the contact points. They were re-evaluated for clinical parameters three months after the surgical correction of their anatomic abnormalities. RESULTS Abnormal nasal septa, enlarged turbinates and other anatomic abnormalities were the most common findings in contact point headaches. Fifty-eight patients underwent surgical correction of intranasal anatomic abnormalities. After follow-up periods of 3-18 mouths, 32 patients were cured, 23 were relieved to an extent, and 3 did not benefit. A significant decrease in the severity and frequency of headaches was noted after surgery. CONCLUSION Pressure from mucosal contact between the septum and lateral nasal wall mucosa is the key cause of contact point headaches, as seen in CT scans of the sinuses and endoscopic examinations. Clinically significant pain may improve after surgical correction of intranasal anatomic abnormalities.

The mRNA Expression of Different Muscle Fibre Types in Denervated Rat Musculus Cricoarytenoideus Posterior / 听力学及言语疾病杂志

Objective To investigate the expression of the mRNA of muscle fibre types in the denervated post cricoarytenoid(PCA)muscle of rat.Methods Unilateral recurrent laryngeal nerve of eight rats were removed.Eight rats were used as controls.The mRNA expression of heavy chain myosin of PCA muscle fibre subtypes was measured with real-time quantitative RT-PCR in control rats and denervated rats 40 days after denervation.Results Compared to the control group,there were no significantly differences in mRNA expression of each muscle subtype between two groups.The ratio of MyHC type I to IIB was increased significantly(P=0.018).Conclusion The increased ratio of MyHC subtype I to IIB suggests the decreased contraction power of denervated PCA muscle.

Proliferation and Apoptosis in the Developing Mouse Cochlear Sensory Epithelium / 听力学及言语疾病杂志

Objective To observe the principles of cell proliferation and apoptosis in the developing mouse cochlear sensory epithelium, and investigate correlation with differentiation of hair cells.Methods The developing inner ears of C57BL/6 embryonic mice,aged from eighth embryonic day (E8) to just natal mice (P0), were observed by transmission electron microscope.Results Cochlear primordium arose at E10. After E14, sensory epithelia began to differentiate. Corti primordium arose at E16, and shapes of supporting and hair cells tend to mature. But the organ of Corti was still poorly developed at P0. Meanwhile Cell karyokinesis of the cochlea arose at E11 ,then gradually increased. But it began to decrease from E14. Cell apoptosis arose at E13.It reached its peak from E14 to E15,then it began to decrease gradually.Conclusion Cell proliferation and apoptosis were inevitable in the developing mouse cochlea.Cell proliferation, cell apoptosis and differentiation of hair cells consequently arose and overlapped each other. Homeostasis between cell proliferation and apoptosis has an important role in the developing mouse cochlear sensory epithelium.